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Pyomyositis is a primary bacterial infection of skeletal muscles presenting with minimal clinical symptoms during the early stages and affects immunocompetent and immunocompromised individuals.1 MRI is a sensitive and specific imaging modality for early detection.1 Here we report a young man with a recent history of type 2 diabetes and recovery from hepatitis E presenting with right thigh pain and minimal erythema diagnosed with right thigh pyomyositis with the assistance of an early MRI.
A 39-year-old man presented with a 5 day history of non-specific pain over the right thigh and a low grade fever. He was diagnosed with type 2 diabetes 3 months ago and had recovered from viral hepatitis E infection 4 weeks ago. Clinical examination revealed mild tenderness over the right thigh with normal overlying skin. Investigations revealed leucocytosis 18×109/l (reference range (RR) 4–12) with a normal creatine kinase (CK) value of 31·7 U/l (RR 24–195), HbA1c of 7·2% and a normal HIV antibody test.
The patient was advised admission to hospital and …
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